Back in the Hospital - Evie's Cardiac Cath Days 1 & 2

Hi everyone, it's Francis blogging for a change. Even though Evie just spent the last two weeks of July in the hospital, we had to re-admit her Sunday afternoon for a cardiac catheterization (aka, cardiac cath or heart cath) to measure the blood flow in her lungs and the blood pressure.

Her doctors were also concerned that the two gortex shunts she had implanted when she was about 4 months old might be too small now and would have to be replaced.

We had to admit her the day before because she needed to receive two doses of a drug called Mucomyst, which helps her kidneys process the contrast dye that is injected into her system during the cardiac cath.

We didn't receive a lot of good news following the cath, and Evie also had a mini-arrest episode, which was quite scary. I'll get to all that, but first, here are some photos from Sunday evening in the hospital with Evie, and Nana and Grandpa Cermak. I'm sorry for the poor photo quality, but I had forgotten my camera during the flurry of activity to get to the hospital, so we took these with Grandpa's cell phone.

Here's Evie in her bed before any IV lines or other sensors are hooked up. She was happy munching away on a bag of Cheetos, courtesy of Nana Cermak's co-worker Jerry (who also gave Evie the Mickey Mouse stacking toy in the picture... which she loved!).



Here's Evie in her hospital gown (that was a medium and was HUGE on her), but she loved it and wouldn't let us take it off. She also had an absolute ball with this stacking toy. Honestly, I thought she was too old for it, but I couldn't have been more wrong. She would multi-task: eating Cheetos with one hand while stacking with the other, and she liked wearing the rings as bracelets.




Evie and Grandpa Cermak (who is sporting his Official DuPage County State's Attorney's Office jacket):




Evie liked how soft the jacket was. You can see the IV line in her ankle here.

Here's Evie with Nana Cermak after Grandpa went home (Nana stayed the night with me in Evie's room). It's nearly 11:00PM at this point and Evie was wiped out after the nurses had to draw blood from her a second time because the first batch hemolyzed. It wouldn't be the last time either, they had to draw again at 5AM. It was rough for her to have to go through that 3 times. She did not like having to get stuck by needles that much and she let the whole floor know it.




Evie was taken back for the cath at 7:30AM and the procedure was over around 11:30AM. They had to enter through her liver, because all of her good femoral arteries are occluded, i.e., obstructed. The doctor performing the procedure, Dr. Javoi, has done all of Evie's prior caths, and overall, Dr. Javoi thought that Evie was "more fragile" and that her body did not take very well to the cath procedure. Evie isn't that big (only 18 lbs), but as her body gets bigger, it will be harder for her heart and lungs to keep up.

He told us that Evie had a "mini-arrest" episode where her blood pressure and heart rate rapidly dropped when the cath tube had passed through two of her heart valves, and they had to perform CPR and chest compressions for about a minute until she recovered.

The lone bit of good news was that her shunts do not have to be immediately replaced. The major bad news was that the Rastelli conduit that was attached to her heart last February (which was her open heart procedure, and which required a 31 day hospital stay), is failing. The conduit (which is not gortex, but is a tube from a cow) is being rejected by her body and is leaking, allowing blood to flow backwards into her heart. I don't' know what the corrective options for this are yet, but her case will be discussed by the surgical team during their weekly Thursday meetings.

There was otherwise no major change in her lungs. Out of the five major lobes that make up your lungs, only Evie's lower right lobe is really working (performing the blood-oxygen exchange) and doing all of the work for her whole body. There is a little function in her lower left lobe, but it is very minor.

Evie is in the Pediatric ICU at Hope (in fact, it's the same room she was in in July!) and will be kept sedated for the rest of the day (Monday) and all night. She currently has a breathing tube down her throat while she's sedated and the docs are monitoring her stats and to make sure there is no bleeding from her liver due to the cath.

They will wake her up on Tuesday morning if all goes well. She will most likely be discharged later in the week. Please keep little Evie in your thoughts and prayers!